P.100 Invasive Validations of a User Independent Oscillometric Device (Arteriograph) for Measuring Augmentation Index and Aortic Pulse Wave Velocity

Abstract

Objective

To validate invasively a new apparatus (Arteriograph), which can measure augmentation index (Aix) and aortic pulse wave velocity (PWVao) simultaneously, within 2–3 minutes. According to the available literature data not any non-invasive device for measuring PWVao was validated with invasive method.

Design and Method

Our comparative study was performed on 36 patients who underwent routine coronarograpy for diagnostic purposes. In 10 cases we measured the brachial Aix with intrabrachial catheter and with Arteriograph, furthermore in 13 cases the intraaortic Aix was compared with brachial Aix on identical pulses. In 25 cases the invasively and non-invasively measured PWVao was compared. In 11 cases we used 2 catheters (inserted from radial and femoral artery) positioned to the aortic root and to the aortic bifurcation and the transit time of the pulse wave was measured on identical heart cycles. In the remnant cases the PWVao was determined with one catheter with pull back from the aortic root to the bifurcation and the transit time was measured using ECG gating. All of the invasively measured transit time was determined by intersecting tangent algorithm on the pulse waves recorded in the aortic root and bifurcation. The aortic root-bifurcation distance was measured by marking the cannula in the aortic root and after its pull back to the bifurcation, and was compared to the non-invasively measured sternal notch-pubic bone distance.

Results

The R values (Pearson’s correlation) between invasively and Arteriograph measured Aix-brachial/brachial, Aix-aortic/brachial and PWVao were 0,92 (p<0,001), 0,90 (p<0,001) and 0,9 (p<0,001) respectively. With Bland-Altman plots the differences were within 2SD in all of the compared parameters and no significant deviation from the zero line was found in different ranges of the measured values. The aortic root-bifurcation and sternal notch-pubic bone distance strongly correlated to each other (R = 0,75, p<0,001) and the difference (0,4 cm) between their means did not prove to be significant (p = 0,36).

Conclusions

The new oscillometric Arteriograph device can measure accurately the central (aortic) and peripheral (brachial) Aix and aortic PWV. The simplicity (due to the oscillometric principle) of the use of this new method to determine stiffness parameters may help to spread more widely, even in primary care the measurement of the arterial stiffness parameters, of which importance is gaining ground rapidly nowadays in the detection of asymptomatic arterial disease.

Atherosclerosis according to its high negative and positive predictive values. Screening of all asymptomatic men over 45 and women over 55 (or at younger age) would be reasonable approach to identify atherosclerosis in early and probably reversible phase if these correlations were confirmed in further large prospective study.